Mini Mikkipedia: Weight loss resistance - why have i stopped losing weight?

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Creators & Guests

Host

Mikki Williden

What is Mikkipedia?

Mikkipedia is an exploration in all things health, well being, fitness, food and nutrition. I sit down with scientists, doctors, professors, practitioners and people who have a wealth of experience and have a conversation that takes a deep dive into their area of expertise. I love translating science into a language that people understand, so while some of the conversations will be pretty in-depth, you will come away with some practical tips that can be instigated into your everyday life. I hope you enjoy the show!

00:00
Hey everyone, it's Mikki here. You're listening to Mini Mikkipedia on a Monday and I want to chat today about weight loss resistance. At some time or another, people who embark on a way of eating to help restore appetite regulation, to improve body composition, to be a leaner version of themselves, can come up against the stall on the scales.

00:29
can get like panicked messages even after a couple of days from someone who hasn't shifted weight and they're like, I've plateaued, there is weight loss resistance here. Now whilst it might seem when you're in the thick of it that a few days of the scale not shifting being some sort of weight loss resistance that your body is trying to fight hard to hold on, that's more likely other factors playing into it.

00:59
the day-to-day change in your scale weight reflects much more of your body's ability to handle water. And it is that sort of month-to-month and even week-to-week weight loss trend that is so much more important in determining your progress with fat loss. And look, sometimes even in certain situations, a weight that remains rather stable for like three weeks or so.

01:26
isn't actually a weight loss plateau or weight loss resistance, because there are people who can see a shift in their weight after holding weight sort of steady for even a few weeks. So if I know that someone is doing quote unquote everything right, then I'm not as concerned if after two weeks the scale hasn't shifted. If it comes to four weeks, then yeah we want to make potentially some changes or four to six weeks, but a couple of weeks is no big deal.

01:53
And if we think about the way that the body holds and handles water, like if I'm thinking about athletes I'm working with, like I've got someone right now and we're trying to get them to a goal weight, which is obviously it's not a particular number, but it's more of a range and we're trying to get them closer to their, what we might determine their sort of, their good race weight. But right now they're just in a holding pattern and it sort of doesn't matter where we are tweaking their diet over the last couple of weeks.

02:23
their body has just stayed relatively stable. And I think in this instance, given that the races in nine or so weeks time, I think that it's the key training sessions that they are undertaking is impacting on what we're seeing in the scale. When you are in the thick of key sessions for your training, that you are, they are either high intensity, really long duration, and there's a lot of fatigue and stress on the body.

02:52
you will hold more water and you may not see that change in the scale weight. So in this instance I know that he's got a few days sort of travel coming up and either side of that there are a couple of easier days so there may be four or five easy days. I expect that we're going to see a shift down in his weight then and that will explain why the weight is sort of holding at this point in time. So do think about that like those fluctuations are actually super normal.

03:20
So if I'm thinking about why you are unable to lose weight and I'm thinking about water balance, other things that spring to mind are, you know, how much does your sodium intake change day to day? And I know that I would have covered this or just do this briefly because that is gonna impact on water retention. If you have over time improved your body composition but you're not seeing shifts in the scale, does it even really matter what the scale says? How you look in the mirror and how your clothes are fitting are particularly better.

03:48
indicators of progress, albeit over time, depending on the amount of weight you will have to lose. You should see shifts in the scale as well. Obviously for females, the time of the menstrual cycle will impact on their water retention and subsequent body weight. A higher carbohydrate intake the day before can also impact on body weight, how early you weigh yourself in the morning, whether or not you've had a bowel motion.

04:13
how late you ate the night before, i.e. how much food might be in your stomach, all of these things are going to affect what you see on the scales day to day, which is why looking at trends over time is much more important. And not just looking at weak trends, but actually looking at trends across the month. That gives you much more insight as to whether or not you're on the right path. A stressed body, just to highlight this, in relation of course to the athlete I just spoke about, but it isn't just athletes.

04:43
allow you to let go of body weight if your brain perceives a dangerous environment. And it doesn't matter whether it's physical stress, emotional stress, psychological stress, your body will react the same way. That's because it's our evolutionary blueprint, which was necessary for our survival for thousands of years. It doesn't matter whether you are not being chased by a saber-toothed tiger or you're having to

05:08
fight for your life or flee for your life, your body will respond in the same way and it struggles to let go of weight in that instance. And as I said, emotional, work-related, metabolic stress, hormonal stress, or even lack of sleep can impact on your body stress response and put your body into this holding pattern. However, before I get on to the sort of hormonal element of weight loss resistance, I do also wanna

05:34
Say that for anyone that is experiencing the sort of long-term plateau in their weight and they're thinking, hmm, is this some sort of hormone issue? Do check in with your habits first. Are you still weighing your food and measuring it properly, not using volumes? You know, you can measure a quarter cup of oats and it could be 70 grams or it could be 50 grams. Tablespoon of peanut butter could be 15 grams or 45 grams. There's quite a bit of variation there. So,

06:02
Are you weighing your food and measuring it properly? And even, are you still planning or prepping your food? Or are the rose-tinted glasses you're wearing shielding you from the fact that you've become a little bit complacent and that you're only really planning and prepping for a couple of meals or three meals a week and you're winging it the rest of the time. And for a lot of people, winging it makes it very difficult to continue to progress.

06:29
Are you even getting enough sleep right now? So you feel refreshed and you're able to hit your workouts and you're able to much more readily avoid the sugar that might be around. So, you know, lack of sleep impacts on our body in a multitude of ways. It is that increase in insulin and cortisol, and I'll speak about these in a little bit, but that will impact on how your body handles different nutrients, particularly carbohydrate, impacts on your cravings, so you're far more likely to head to sugar.

06:59
It impacts on your motivation, so you might be less likely to hit that workout if you've had a night of poor sleep. So all of these things can impact either immediately or downstream on your overall progress with your fat loss. And are you even exercising? So if I am talking to someone and they're concerned about their fat loss plan, yet they are rather sedentary, then one of the first things you should do is exercise. And yes, of course,

07:28
in part because exercise does burn calories and that can help with that calorie deficit. But we do know there's a strong relationship between being sedentary and appetite regulation. And interestingly, when you look at the research, people who are fall into the most sedentary category are less in tune with how...

07:48
hungry they are and how much food they need so they are more likely to overeat. Whereas if you are moderately active you're more in tune with those appetite signals and can better regulate how much you eat. Are you hydrated? So often people are dehydrated through the day so their heart has to work harder to pump the blood around their body so they feel a bit more fatigued then they're more likely to reach for sugar for an energy hit or they think they're hungry but actually they're just thirsty.

08:16
And also just are you moving in everyday life? When you are in a calorie deficit, you are less likely to actually move because our non-exercise activity can reduce, even unknowingly. You know, we become less fidgety. We're less likely to walk different places if we can, you know, chuck someone an email around the office, for example. So actually being deliberate about the number of steps and the movement you're getting outside of that structured training can impact weight loss as well.

08:45
So it might not be that your body's become weight loss resistance from a sort of hormonal perspective. It might just be these changes in habits and behaviors that are leading to this weight loss plateau. So if it is hormones, what hormones are we talking about? And look, this is a mini-Micipedia episode. This isn't a three-hour masterclass on hormones. So it'll be a brief touch on some of the major ones. There'll be much more that you could sort of do a deep dive in, and I might in a future episode.

09:15
But firstly, testosterone. In men, if this is low, it can make it more difficult to build muscle and it is associated with increased fat mass. And testosterone can be low in a super stressed environment and super stressed body. When testosterone is increased to normal physiological ranges, this does allow for better body composition and is part of a successful approach to lose body fat. Therefore, low testosterone can explain to some extent

09:43
the trouble that some men may have with weight loss resistance. But in women too, low testosterone can be an issue. This is related to low libido and an inability to build muscle. So you might be in the gym four times a week, but you're not seeing the gains for that. This in itself is a problem as we lose muscle heading into menopause if we don't take measures to hold onto it. And it is increasingly difficult, albeit not impossible, to build.

10:12
Low testosterone can also impact on mood and fatigue for both sexes, which impacts on food choices and the ability to exercise. In fact, in the research there are mixed results. So low testosterone potentially impacts for postmenopausal women only and isn't an issue for women before they head into menopause. And just so you know, in a case of a men, men's levels of testosterone absolutely decline with age.

10:40
And with women, the same thing applies as well. So as estrogen and progesterone are sort of all over the show and moving out, testosterone is also on a slow decline. However, it's a mixed bag because it isn't just the hormones. It is obviously how that then impacts our behavior. And I do also want to reiterate that. And just as a little beacon of hope that there are things that you can do. On the flip side though, too much free testosterone relative to estrogen

11:10
particularly around perimenopause, is associated with increased visceral fat tissue. So it's not that you might not have hugely high levels of testosterone, but in relation to the amount of estrogen that's available, this can impact on ability to lose fat. So I guess it's fair to say that you do need a balance. And typically testosterone is prescribed based on symptoms rather than your blood levels. And I did speak to Nikki and Lara a little bit about this

11:39
joint podcast that we did some months ago. There is scarce research that low testosterone could be a driver of weight loss resistance in women. However, high testosterone relative both to estrogen as I mentioned, but also absolute high amounts in conditions such as polycystic ovarian syndrome is linked to insulin resistance, body fat gain and weight loss resistance as well. So estrogen is another hormone which is obviously worth talking about.

12:08
or more specifically estradiol, which is a metabolite of estrogen that is linked to metabolism, appetite regulation, and insulin sensitivity, and is the one that they measure in the bloodstream when you get your levels of estrogen measured. Levels drop as women head into menopause, as you know, and this does change how glucose from what we eat, carbohydrate, it changes how glucose is handled in the body, which means that more glucose is stored rather than used

12:37
as energy. The drop in estradiol also impacts on fat gain around the midsection. This has implications for fat gain, however the fluctuating and at times super high estrogen doesn't necessarily mean that someone is resistant to losing weight. It is more likely that their current habits or weight loss strategies are not conducive to the current hormone environment. And so you do just need a different approach, which is of course why I talk a lot about protein

13:07
and movement and things like that, because those are the strategies that can really assist with fat loss now. Whereas just skipping meals, dropping calorie intake, and lowering the overall amount of food, which used to work in your 20s, is far less effective. Cortisol and adrenaline are two stress hormones that are released in response to perceived stress. These are the catechol means, which I mentioned earlier. And that stress, as I also mentioned, can be both physical and emotional.

13:36
your body doesn't know the difference. Adrenaline is initially released to increase blood flow, raise heart rate, and liberate glucose from stored glycogen in the liver. Cortisol works in the longer term to sustain this response, which is perfect if you are running for your life or fighting for your life. If this isn't your situation, and it's just that usual run of the mill life, work, relationship stress that we can all experience, over time the elevated cortisol can suppress fatty acid metabolism,

14:06
increased muscle breakdown, increased cravings for high sugar and high fat foods, and increased insulin levels. These will all contribute to weight loss resistance. And again, this is in part a physiological response and in part related to the subsequent behaviors that can occur. To my mind, these all go hand in hand. There may be that hormone underpinning, but it is changing how you act. Now, leptin and ghrelin are two hormones that help us control

14:36
Leptin is released in response to food intake signaling that we're full and Grelin on the other hand is released to signal hunger. When leptin was discovered interestingly scientists were so excited that it was a hormone that could play a huge role in reversing the effects of obesity. This was because preclinical or rodent trials revealed that removing the leptin gene caused significantly fatter mice and I remember seeing this picture of this

15:04
We called it the OB, I think it was the OB gene mouse actually. And my lecturer at the time, Rachel Taylor, who's an excellent researcher down at University of Otago, she showed us this picture and it was a normal mouse and it was this absolutely massively fat mouse. And scientists were like, look what happens when you remove lectin. This mouse gets fatter. Subsequently as well, when they put back lectin into that system, that mouse got leaner again. So

15:33
What the scientists thought was that obese people must be low in leptin and therefore if we increase their leptin levels this will allow them to lose weight. Unfortunately when levels of leptin were measured in people with excess adiposity it was revealed that they had increased levels of leptin and not lower levels. And so further research found that in people with obesity the brain can become resistant to the leptin signal and require more calories to feel satisfied.

16:02
So it was a sign of lectin resistance. There is no diagnostic test to determine if an individual has lectin resistance, and it is often a diagnosis based on the exclusion of other conditions. Cravings, never feeling full even after meals, a high amount of belly fat, and difficulty losing weight are all symptoms of lectin resistance, but these are also symptoms of poor habits and lifestyle, of fluctuating sex hormones,

16:31
of insulin resistance. So, you know, there are a range of different hormones that could be playing into this. And while it might be expected that ghrelin works in synchrony with leptin, so it rises when leptin is low and vice versa, the impaired signaling of leptin may also impact on ghrelin and the brain may not suppress ghrelin production as effectively. And remember ghrelin is released in response to hunger. So this can lead to an increased appetite.

16:57
So it's fair to say that these interactions aren't well understood, though they may play into ongoing issues with appetite regulation. And with regards to leptin resistance, a couple of the recommendations that I've seen being made are around ensuring adequate sleep because leptin levels are higher after sleep deprivation, and also limiting fructose or free fructose consumption because fructose can play a role in leptin production.

17:27
So interestingly, high fructose intake, particularly from added sugars like sugar sweetened beverages can contribute to leptin resistance. And in part, it could be to do with how fructose is metabolized. So unlike glucose, fructose doesn't stimulate insulin secretion, which as you probably know, insulin is the hormone that helps regulate blood sugar levels. So insulin and a high fructose intake therefore can disrupt the normal insulin response, which

17:56
can then in turn affect leptin signaling because insulin also plays a role there. So it's this interaction between fructose and insulin which can impact on that leptin resistance. But note that this isn't just fructose in general. It's not fructose from whole fruits. It's excess fructose intake, more likely coming from free added sugars in the diet. And of course, our thyroid hormone can play a role in weight loss resistance. And a lot of people

18:24
do have suboptimal thyroid function. This is in part a function of aging actually, because we see this in both men and women. Your thyroid is responsible for multiple things, and as adults, its main role is in energy metabolism. It produces the T4 hormone, and around about 20% of the active T3 that is required in the body. The remaining T3 is produced

18:50
with the conversion of T4 through a process known as deiodination. These are released into the bloodstream in response to the signal from the pituitary gland. The thyroid stimulating hormone is the most regularly measured biomarker for thyroid function and it is what your doctor will order if you go in to ask about your thyroid, or you're having issues with fatigue, etc. And when it is detected that there isn't enough T4 present, and to some extent T3, the pituitary gland will release more TSH.

19:20
So higher isn't better. If too much T4 is detected, it will slow down the production of that TSH. But ultimately a suboptimal thyroid function will impact someone's ability to lose body fat. And as I said, this is a common complaint as we age. But you know, thyroid is actually pretty complex. It's not as simple as just giving someone a thyroid medication, a T4.

19:45
Some of the major issues with thyroid can definitely be nutritional. So it might be that there isn't enough iodine to produce T4 or T3 hormones. Or it could be a deficiency in zinc or selenium to help the conversion of that T4. Too low iron stores can also result in suboptimal thyroid function. Too few calories will decrease thyroid function and the body's ability to conserve energy in an environment of energy scarcity, of which is dieting, isn't it?

20:11
And while anecdotally there are reports of subclinical thyroid disorder with too little carbohydrate, if you look in the literature, the data is really mixed and inconsistent. And it is often compounded with low calories. So you don't know whether it is the low carbohydrate that's causing this issue or is it low calories in general. So the thyroid is pretty complex. And I say this because so many people are on thyroid medication and just don't even feel that much better. If your body is low in T4 and you

20:39
give it T4 and that is the only handbrake on the thyroid function, then absolutely it'll work better. However, if your body cannot convert T4 to T3 through to nutritional deficiencies or inflammation that is preventing the uptake of thyroid hormone onto thyroid receptors, then just merely giving thyroid medication is likely not going to fix the issue. So there's a real balance here.

21:09
Getting to the bottom of that thyroid issue, if there is one, can really go a long way to helping with weight loss resistance. But thyroid medication is likely not a magic bullet for a lot of people. And then the last hormone I wanna touch on is of course insulin. And it's come up a little bit throughout this conversation because a lot of things interact, like with cortisol, like with leptin, like with estrogen and low levels of estradiol.

21:36
So insulin to remind you is a nutrient storage hormone. It doesn't just take glucose out of the bloodstream and deliver it to the tissues that need it. It can also store and does store fatty acids. And there is a strong relationship between insulin resistance and ability to burn fat and lose weight because high levels of insulin suppresses fatty acid oxidation and pots your body much more into storage mode than it does burning mode.

22:05
much like leptin resistance, if you are insulin resistance, your body has to produce more insulin to dispose of the glucose compared to what it otherwise would. And this can also increase our stress hormones, levels of inflammation in the body, it changes our blood sugar, our ability to handle glucose. So we have fluctuating blood sugar levels. So it can impact on fatigue, appetite,

22:35
cravings and all of those other downstream behaviors and feelings which I've already discussed. Looking at fasting levels of insulin is one way to determine whether or not you have insulin resistance but there are some doctors who don't really bite into that because fasting insulin can be quite labile so it can shift day to day depending on what happened the night before. Looking at the levels of triglycerides and HDL in your cholesterol

23:04
if you get that measured in a fasted state, can give you some indication of whether insulin resistance is present, because a high ratio is a proxy for insulin resistance and subsequent metabolic syndrome. If you store a lot of visceral fat or fat around your middle, that's more likely that you have insulin resistance. And of course, if you have a HbA1c or A1c marker that is

23:30
high and potentially in that pre-diabetic range, that is also a good sign that you are insulin resistance. And if your body can't dispose of glucose well, then you're not able to put energy in your cell and therefore it makes it very difficult to burn energy and lose body fat. So insulin resistance is certainly another reason for weight loss resistance. And while losing weight can certainly improve on conditions such as insulin resistance and

24:00
leptin resistance, these two conditions may require different strategies than what you've been doing for losing weight. And whilst I'm not going to go into a bunch of the different methods here, because again this is a mini-Macapedia episode, I can certainly touch on them next time as to how to shift your metabolism from this resisted state into one that burns energy effectively, which will ultimately lead to fat loss in the end. Anyway, hopefully this just gave you a little bit of information and insight into

24:29
what might be going on if you're experiencing weight loss resistance. And of course you can always touch base with me, DM me on threads, Instagram and Twitter @mikkiwilliden, Facebook @mikkiwillidenNutrition. Head to my website, mikkiwilliden.com and book a one-on-one call with me. All right team, have a great week.